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Using AI to negotiate a $195k hospital bill down to $33k

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Re: Using AI to negotiate a $195k hospital bill down to $33k

#751

Post by trollbridge »

t0mas88 wrote: post #654
thatfrenchguy wrote: post #629

Earlier quoted context omitted.

In the US, you'll be billed the maximum out of pocket for your health insurance whether your little one is in the ICU for months or whether it was a easy delivery though, so at least birth is a predictable medical expense.

If you have health insurance... Which is not automatically a thing for many Americans, and it seems even more with current political trends.

If someone doesn’t have health insurance in my state, they get sent to financial counselling/assistance and signed up for Medicaid, CHIP, or HCAP.

I asked one of their counsellors once if they ever have any ultra wealthy people who don’t have insurance and also don’t qualify for any assistance. (This was at a children’s hospital with a Level IV NICU.) She said she was unaware of that ever happening, other than very wealthy foreigners who would prepare in advance, arrange payment in advance, fly in, and have a special procedure done.

Overall, in many states, it is logistically impossible to have an unaffordable bill and also not qualify for assistance. The worst situation actually is the person who has insurance but has high deductibles and copays.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#752

Post by maxerickson »

tptacek wrote: post #748
maxerickson wrote: post #747

Earlier quoted context omitted.

You think it's obvious that "lesuorac" was scoping their comment to people that have an FSA with an HDHP? Doesn't read that way to me.

It's obvious in that they specifically referred both to HSAs (not FSAs), and to HDHPs, which depend on HSAs, not FSAs. FSAs are not a kind of HSA. So, yeah. Little bit.

Which they? The comment I replied to literally says:

"If you have a FSA I strongly suggest that you get an HSA instead."

Did you mean to reply to them?

Re: Using AI to negotiate a $195k hospital bill down to $33k

#753

Post by tsimionescu »

Aurornis wrote: post #438
kwanbix wrote: post #363

Earlier quoted context omitted.

As a non-american (from South America) who lived in both USA an Europe: Yes, in USA you get much more money, like you said 2x~5x, but then: University is expensive as fck. Health care is expensive as fck. You have 5 days of paid sick leave per year in most companies. You have 10 days of paid holidays per year in most companies. In contrast, in Europe: University was cheap or free. Healthcare is cheap and universal. I…

> University is expensive as fck. One thing that's hard to understand from the outside is that almost nobody actually pays those mind-blowing $60K/year tuition prices. US universities charge on a sliding scale based on the applicants' families' ability to pay. For an extreme example: Harvard's tuition is nominally $60K per year, but for families earning $200K or less it's $0. Many prestigious universities follow simi…

It's very funny to see the US perspective here. $30-40k debt for a new graduate of an average university sounds crazy expensive to virtually everyone outside of the USA, I would bet. I paid $0 for my university, as did most of my colleagues, but even if I had had to pay the tuition, it would have amounted to $4k total for a 4-year bachelor's degree, or $6.5k total for a 6-year bachelor's + master's, at one of my country's premier state universities (and consider that private universities are a joke here, just diploma mills).

Granted, none of the top universities in my country even makes it to the top 500 in the world, so maybe this isn't a completely fair comparison? Actually, it's expensive by some other EU country standards - public schools in France and Germany, including PSL (ranked 28th in the world) and TUM (ranked 22nd), are free for all EEA applicants, with some nominal yearly registration fees (amounting to $1k in total for a 4-year degree). A more expensive school, like ETH Zurich (rank 7 in the world), is $4500 total for a 4-year degree if you're a Swiss citizen or EEA citizen with a Swiss work permit; it's triple that for an international student.

So yeah, when we say "university is crazy expensive in the USA (and probably UK too)", we're actually talking about the $30-40k numbers you're looking at. $200k and so are almost inconceivable to us.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#754

Post by brightball »

chrisgeleven wrote: post #245

I fought insurance over this past summer after they declined covering a life saving surgery for my 6-year-old child at the last minute. We were in despair that my child's life was at risk each day we waited because of insurance incompetence. ChatGPT literally guided me through the whole external appeal process, who to contact outside of normal channels to ask for help / apply pressure, researched questions I had, hel…

In that same vein, I used a public adjuster once after a small electrical fire torched a room in my house. The insurance adjuster was great, his manager was awful and made a difficult experience much worse.

Without getting into details, the moment I realized that he was being intentionally obtuse I started looking into options.

First contacted an attorney who essentially said, “Yes, I can do it but I’m going to cost a lot and the insurance company won’t reimburse you for my time.”

Kept looking and discovered public adjusters were a thing. Did some research, found one who was reputable and he took me on for free. Pretty sure we used net, about 2-4 hours of his time.

He told me exactly what was going to happen, how the insurance company was going to react and it played out exactly as he said.

1. He requested a process to take the valuation of everything damaged in the fire to a 3rd party arbiter.

2. Insurance company will send you a letter saying it’s not time for that yet. We will proceed anyway. And we did.

3. He will nominate 3 arbiters and the insurance company will nominate 3 arbiters. Neither will select either of the others nominees and an independent 3rd party will select one instead.

4. The moment the insurance company realizes the valuation of your things will be outside of their control, they will become extremely agreeable. And they did.

And honestly the only thing I really wanted was another week in a hotel for my family because the company cleaning my house of smoke was short staffed over the holidays. Would have cost them likely $1,000 but instead he escalated the situation dramatically.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#755

Post by tsimionescu »

CivBase wrote: post #749
kwanbix wrote: post #363

Earlier quoted context omitted.

As a non-american (from South America) who lived in both USA an Europe: Yes, in USA you get much more money, like you said 2x~5x, but then: University is expensive as fck. Health care is expensive as fck. You have 5 days of paid sick leave per year in most companies. You have 10 days of paid holidays per year in most companies. In contrast, in Europe: University was cheap or free. Healthcare is cheap and universal. I…

> University is expensive as fck. Health care is expensive as fck. University isn't near as big of a problem. That's not something the blindsides you like health care expenses. Nobody is making you spend $300k on university. Got my engineering degree at a public university for ~$100k in total and had it paid off 5 years after graduation. But a $195k hospital bill is something I'd never be prepared for. Nobody chooses…

For $100k, you could pay the tuition fees for 4-10 (depending on exact school choice) of the best universities in Europe outside the UK combined - and I'm talking of the foreign student fees, not the much lower tuitions that EU citizens get.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#756

Post by com2kid »

Aurornis wrote: post #438
kwanbix wrote: post #363

Earlier quoted context omitted.

As a non-american (from South America) who lived in both USA an Europe: Yes, in USA you get much more money, like you said 2x~5x, but then: University is expensive as fck. Health care is expensive as fck. You have 5 days of paid sick leave per year in most companies. You have 10 days of paid holidays per year in most companies. In contrast, in Europe: University was cheap or free. Healthcare is cheap and universal. I…

> University is expensive as fck. One thing that's hard to understand from the outside is that almost nobody actually pays those mind-blowing $60K/year tuition prices. US universities charge on a sliding scale based on the applicants' families' ability to pay. For an extreme example: Harvard's tuition is nominally $60K per year, but for families earning $200K or less it's $0. Many prestigious universities follow simi…

My mom was a school bus driver and my dad was a laborer retired on disability. I got zero aid except for loans.

I went to a 2nd tier in-state school 20 years ago and even that cost 10k a year by the time housing, food, and books, were paid for.

Plenty of people who can barely avoid it end up paying a large chunk of $.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#757

Post by tptacek »

maxerickson wrote: post #752
tptacek wrote: post #748

Earlier quoted context omitted.

It's obvious in that they specifically referred both to HSAs (not FSAs), and to HDHPs, which depend on HSAs, not FSAs. FSAs are not a kind of HSA. So, yeah. Little bit.

Which they? The comment I replied to literally says: "If you have a FSA I strongly suggest that you get an HSA instead." Did you mean to reply to them?

You are I are both commenting on a subthread started by a comment that included "What you're describing isn't true for people on High Deductible Health Plans, and those plans are a bit of a racket because they're frequently paired with HSAs where [...]", none of which is true. I don't care about FSAs and am not trying to argue with anybody about them, but that preceding comment is very wrong about HSAs and HDHPs.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#758

Post by com2kid »

no_wizard wrote: post #684
maxerickson wrote: post #597

Earlier quoted context omitted.

A lot of people with FSAs will have insurance that disqualifies having an HSA. I have the paranoid idea that they designed FSAs in such a goofy way for budget scoring and it drives me nuts.

>A lot of people with FSAs will have insurance that disqualifies having an HSA. Which should be illegal. It should be only HSA across the board. Its nonsensical that this is a thing. I'd love an HSA, but I can't due to my plan (can't do a high deductible plan for $reasons). I think there may be some loophole in setting up an independent HSA but I haven't looked into it enough, only recently heard of such a scheme

FSA is just a 30%-ish discount on medical expenses. It is useful for eye glasses and such. A lot of QoL services qualify for FSA, including weight loss coaches and therapy.

Heck my (prescription) meta ray bans were paid for in part with FSA funds.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#759

Post by KnuthIsGod »

This is why hospitals go broke. While it is great for the individual, society suffers.

Here in Australia, our 2nd biggest private hospital owner has just gone broke.

At a fire sale, there was so little interest in buying the hospitals that many will be shut down.

The rest of the unsalable hospitals will be shoved into a stripped down charitable tax exempt trust so that the creditors ( banks and pension funds ) can recoup a small amount of the money they lent the hospitals.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#760

Post by Geeek »

dekhn wrote: post #34

I had an odd but successful experience with medical billing recently. My daughter went to urgent care for an urgent problem; after things were mostly cleared up, they transferred her by ambulance to an ER (even though there was no emergency). Both the urgent care and ER were handled by our insurance but the ambulance company sent us a large bill ($4K for a short drive) which felt too large to us (they had already tri…

Whats the service that negotiates medical bills?
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